NCEH in
Partnership With Rhode Island
The National Center for Environmental Health (NCEH) is part of the
Centers for Disease Control and Prevention (CDC). NCEH’s work
focuses on three program areas: identifying environmental hazards,
measuring exposure to environmental chemicals, and preventing
health effects from environmental hazards. NCEH has approximately
450 employees and a budget for 2004 of approximately $189 million;
its mission is to promote health and quality of life by preventing
or controlling diseases and deaths that result from interactions
between people and their environment.
NCEH and partners throughout Rhode Island collaborate on a
variety of environmental health projects throughout the state. In
fiscal years 2000–2003, NCEH awarded more than $4.6
million in direct funds and services to Rhode Island for
various projects. These projects include activities related to
asthma, newborn screening quality assurance, and childhood lead
poisoning prevention. In addition, Rhode Island benefits from
national-level prevention and response activities conducted by
NCEH or NCEH-funded partners.
Identifying Environmental Hazards
NCEH identifies, investigates, and tracks environmental hazards
and their effects on people’s health. Following are examples of
such activities that NCEH has conducted or supported in Rhode
Island.
Asthma
- Addressing Asthma from a
Public Health Perspective—NCEH is funding Rhode Island
to implement statewide comprehensive asthma-control plans.
Funding began in fiscal year 2001 and continues through fiscal
year 2006.
- Managed-Care and Community
Intervention—NCEH is funding a demonstration project in
which the Neighborhood Health Plan of Rhode Island, a
nonprofit managed-care organization, is working with the
communities of Woonsocket, Central Falls, and
Pawtucket to implement a broad, community-based intervention
to improve health outcomes for children with asthma. Funding
began in fiscal year 2003 and continues through fiscal year
2004.
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Measuring Exposure to Environmental Chemicals
NCEH measures environmental chemicals in people to determine how
to protect people and improve their health. Following are examples
of such activities that NCEH has conducted or supported in
Rhode Island.
Funding
- Antiterrorism Funding to
Increase State Chemical Laboratory Capacity—In fiscal year
2003, CDC provided more than $508,000 to assist Rhode Island
in expanding chemical laboratory capacity to prepare and
respond to chemical terrorism incidents and other chemical
emergencies. This program expansion will allow for full
participation of chemical-terrorism response laboratories in the
Laboratory Response Network. NCEH has begun to fund laboratory
development and the purchase of state-of-the-art equipment in
Rhode Island’s state public health laboratory in support of
developing a network of chemical laboratories and of
transferring technology to measure chemical agents.
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Services
- Newborn Screening Quality
Assurance Program―NCEH provided proficiency-testing services
and dried blood-spot quality-control materials to monitor and
help ensure the quality of newborn screening program operations
in the state. The importance of accurate screening tests for
genetic metabolic diseases cannot be overestimated. Testing of
blood spots collected from newborns is mandated by law in almost
every state to promote early intervention that can prevent
mental retardation, severe illness, and premature death.
- Lipid Standardization
Program―CDC provides accuracy-based analytical measurement
standardization support to a lipid research laboratory in
Rhode Island involved in one or more ongoing lipid
metabolism longitudinal studies or clinical trials investigating
risk factors and complications associated with cardiovascular
disease.
- Blood Lead Laboratory
Reference System (BLLRS)—In Rhode Island, one
laboratory participates in NCEH’s standardization program to
improve the overall quality of laboratory measurements of blood
lead levels. This program assists laboratories nationwide in
evaluating their performance on these critical laboratory tests.
NCEH provides BLLRS materials to the laboratories four times a
year without charge.
- Helping State Public Health
Laboratories Respond to Chemical Terrorism—NCEH is working
with Rhode Island’s public health laboratory to prepare
state laboratory scientists to measure chemical terrorism agents
or their metabolites in people’s blood or urine. NCEH has
conducted training on operating state-of-the-art laboratory
instruments and on using specific methods to analyze these
agents. Additionally, NCEH has transferred methods for measuring
cyanide and trace metals to the state laboratory and has
instituted a proficiency testing program to test the
comparability of analytical results from the state laboratory
and NCEH.
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Preventing Health Effects from
Environmental Hazards
NCEH promotes safe environmental
public health practices to minimize exposure to environmental
hazards and prevent adverse health effects. Following are examples
of such activities that NCEH has conducted or supported in
Rhode Island.
- Rhode Island Childhood Lead
Poisoning Prevention Program—The Rhode Island Childhood
Lead Poisoning Prevention Program (RI CLPPP) has received
CDC funding since 1990. The purpose of the program is to provide
screening services, nonmedical and medical case management,
environmental management, laboratory services, consultation, and
educational outreach services to the community. In Rhode Island,
the number of children younger than 6 years of age who were
screened for lead increased 2.8% from 1997 to 2001—from 33,826
to 34,765. At the same time, the number of children younger than
6 years of age with elevated blood lead levels has decreased 35%
from 1997 to 2001—from 3,119 to 2,026.
In fiscal year 2003, NCEH awarded funding to RI CLPPP to support
its comprehensive Childhood Lead and Surveillance Program. The
purpose of this program is to provide the impetus for the
development, implementation, expansion, and evaluation of state
and local childhood lead poisoning prevention program
activities, which include statewide surveillance capacity to
determine areas at high risk for lead exposure.
Rhode Island has a critical shortage of affordable housing. An
estimated 80% of Rhode Island’s housing units have lead-based
paint, and many of these deteriorating units are rental
properties. The housing shortage provides little incentive for
landlords to maintain lead-safe housing and places families in
the position of having to compromise their children’s health.
- Elevated Blood Lead Levels
Among Dominican Children—In June 2003, in connection with
unexplained elevated blood lead levels in three young Dominican
children, the Rhode Island Department of Health learned
about a yellow/peach-colored powder called litargirio. At
the request of the state epidemiologist, CDC assisted in an Epi-Aid
investigation to assess the prevalence of litargirio use
and to determine the risk factors associated with litargirio use
among Latinos in Providence.
The litargirio that affected these children had been
purchased from the Dominican Republic by a relative, but it also
is available at local botanicas that cater to the Latino
community. People in the Latino community use litargirio
as a deodorant/antiperspirant and as a treatment for fungal
infections and burns. Laboratory analysis of litargirio
samples that affected these children revealed that they
contained up to 79% lead. Before these cases in Rhode Island, no
cases of lead poisoning associated with the use of litargirio
had been reported.
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Resources
NCEH develops materials that
public health professionals, medical-care providers, emergency
responders, decision makers, and the public can use to identify
and track hazards in the environment that threaten human health
and to prevent or mitigate exposure to those hazards. NCEH’s
resources cover a range of environmental public health issues,
including air pollution and respiratory health (e.g., asthma,
carbon monoxide poisoning, and mold exposure), biomonitoring to
determine whether and how much of selected chemicals in the
environment get into people, childhood lead poisoning, emergency
preparedness for and response to chemicals and radiation,
environmental health services, environmental public health
tracking, international emergency and refugee health, laboratory
sciences as applied to environmental health, radiation studies,
safe disposal of chemical weapons, specific health studies, vessel
sanitation, and veterans’ health.
For more information about NCEH programs, activities, and
publications and other resources, contact the NCEH Health Line
toll-free at 1-888-232-6789, e-mail NCEHinfo@cdc.gov, or visit the
NCEH Web site at
www.cdc.gov/nceh.
May 2004
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